Pelvic exams and cervical cancer screening in patients with anorectal malformations
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In brief
In brief
Cross-sectional study of 54 female patients with anorectal malformations found 79.6% had undergone pelvic exams and cervical cancer screening, though patients with complex malformations reported higher pain scores. Critical finding: only 2 of 15 patients with didelphys uterus had both cervices screened, highlighting need for provider awareness of anatomic variations in ARM patients.
Written by the GCMD Library team from the article.
Abstract
Purpose
Congenital or acquired anatomic differences of the genital tract in patients with anorectal malformations (ARM) may make pelvic exams more challenging. The purpose of this study was to describe office-based pelvic exams and cervical cancer screening among female patients with a history of ARM.
Methods
This was an IRB approved, cross-sectional study of female patients with ARM who completed our Reproductive Health Surveys from November 2021 to March 2022.
Results
Fifty-four patients with ARM were included in the study. Ages ranged from 22 to 80 years (mean age 34.5 years). Thirty-four patients had a cloaca, 16 had an ARM other than cloaca, and four patients had a complex malformation. Most patients (79.6%) reported having had a pelvic exam in the office. On a scale of 0–100, the mean pain score with pelvic exam was 42. Pain scores were higher for patients with complex malformations and neo-vagina. Forty-three participants (79.6%) had cervical cancer screening. Fifteen participants (28%) had a didelphys uterus but only two patients specified that both cervices were screened for cervical cancer.
Conclusion
The majority of female patients with ARM had cervical cancer screening in clinic, those with complex malformations reported greater discomfort. Providers should be aware of barriers to performing pelvic exams in patients with ARM as well as the need to screen both cervices in didelphys uterus.